Biomaterials Cluster, Bernal Institute, University of Limerick, Limerick, Ireland; School of Engineering, Faculty of Science and Engineering, University of Limerick, Limerick, Ireland.
Biomaterials Cluster, Bernal Institute, University of Limerick, Limerick, Ireland; School of Engineering, Faculty of Science and Engineering, University of Limerick, Limerick, Ireland.
J Mech Behav Biomed Mater. 2023 Jul;143:105923. doi: 10.1016/j.jmbbm.2023.105923. Epub 2023 May 22.
Paediatric urinary catheters are often necessary in critical care settings or to address congenital anomalies affecting the urogenital system. Iatrogenic injuries can occur during the placement of such catheters, highlighting the need for a safety device that can function in paediatric settings. Despite successful efforts to develop devices that improve the safety of adult urinary catheters, no such devices are available for use with paediatric catheters. This study investigates the potential for utilising a pressure-controlled safety mechanism to limit the trauma experienced by paediatric patients during inadvertent inflation of a urinary catheter anchoring balloon in the urethra. Firstly, we establish a paediatric model of the human urethra using porcine tissue by characterising the mechanical and morphological properties of porcine tissue at increasing postnatal timepoints (8, 12, 16 and 30 weeks). We identified that porcine urethras harvested from pigs at postnatal week 8 and 12 exhibit morphological properties (diameter and thickness) that are statistically distinct from adult porcine urethras (postnatal week 30). We therefore utilise urethra tissue from postnatal week 8 and 12 pigs as a model to evaluate a pressure-controlled approach to paediatric urinary catheter balloon inflation intended to limit tissue trauma during inadvertent inflation in the urethra. Our results show that limiting catheter system pressure to 150 kPa avoided trauma in all tissue samples. Conversely, all of the tissue samples that underwent traditional uncontrolled urinary catheter inflation experienced complete rupture. The findings of this study pave the way for the development of a safety device for use with paediatric catheters, thereby alleviating the burden of catastrophic trauma and life changing injuries in children due to a preventable iatrogenic urogenital event.
儿科导尿管在重症监护环境中或用于治疗影响泌尿生殖系统的先天性异常时通常是必要的。在放置这些导管时会发生医源性损伤，这突出表明需要一种能够在儿科环境中发挥作用的安全装置。尽管为提高成人导尿管安全性而成功开发了一些装置，但尚无此类装置可用于儿科导尿管。本研究探讨了利用压力控制安全机制来限制儿科患者在无意中使尿道内导尿管锚固球囊充气时所经历的创伤的潜力。首先，我们通过在越来越多的产后时间点（8、12、16 和 30 周）对猪组织进行特征描述，建立了使用猪组织的人类尿道儿科模型，以建立猪组织的机械和形态特性。我们发现，在产后第 8 周和第 12 周采集的猪尿道具有统计学上与成年猪尿道（产后第 30 周）不同的形态特性（直径和厚度）。因此，我们利用产后第 8 周和第 12 周的猪尿道组织作为模型，评估一种压力控制方法来控制儿科导尿管球囊充气，以限制在无意中充气到尿道时对组织造成的创伤。我们的结果表明，将导管系统压力限制在 150kPa 可避免所有组织样本的创伤。相反，所有经历传统不受控制的导尿管充气的组织样本都经历了完全破裂。这项研究的结果为儿科导管使用的安全装置的开发铺平了道路，从而减轻了由于可预防的医源性泌尿生殖事件而导致的灾难性创伤和改变儿童生活的创伤的负担。
